राष्ट्रीय प्रौद्योगिकी संस्थान आं ध्रप्रदे श

NATIONAL INSTITUTE OF TECHNOLOGY ANDHRA PRADESH

Near National Highway No. 16, Kadakatla, Tadepalligudem – 534101
West Godavari District, Andhra Pradesh, India.
Annexure-B

APPLICATION FORM FOR FEE REMISSION OF TUITION FEE FOR THE A.Y. 2023-24.

S. No Particulars

1. Name of the Student

2. Reg.no & Roll no.

3. Branch

4. Year & Semester: (BTech-I/II/III/IV)

5. Aadhaar number of the student

6. Fee Remission Category: (MEB/OEB)

7. E-mail ID

8. Mobile number of the student

9. Name of the Father

10. Father’s occupation

11. Aadhaar number of the father

12. Name of the mother

13. Mother’s occupation

14. Aadhaar number of the mother

15. Present Postal Address

17. Annual Income of Family

(i) Father’s Annual Income

(ii) Mother’s Annual Income

(iii) Annual Income from other source, (if

any)

(iv) Total Family Annual Income

I declare that the information provided by me is true and I will abide by the rules and regulations of the
institute in this connection.

Signature of the Student Signature of Father/Mother/Guardian

with date with date